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Low‐budget, single‐session elimination of CIED pocket infection
Author(s) -
Roshdy Hisham,
Seaoud Elshaimaa,
Elbelbesy Radwa
Publication year - 2021
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14133
Subject(s) - medicine , surgery
Background The dramatic increase in the use of cardiovascular implantable electronic devices (CIED) was associated with an increased rate of CIED infection, which has a high management cost. Aim of the Study To test the safety and efficacy of a single‐session protocol, aiming to reuse the infected pocket side and the same device and leads in patients with CIED pocket infection. Patients and Methods We included patients with isolated pocket infection between January 2015 and November 2019. The Patient was prepared by taking a swab for culture and sensitivity before the procedure. The pocket was debrided and the capsule was removed, the pocket was rinsed with povidone‐iodine and hydrogen peroxide mixture, then packed with gauze sponge soaked with povidone‐iodine. The device was debrided using ultrasonic irrigation and sterilized using gas plasma. The device was reimplanted and the wound was closed in layers. Results During the period of the study, we had 12 patients with isolated pocket infection. Nine presented with erosion, two with impending erosion, and one with a chronic sinus. Patient's age was 61.5 ± 7.64 years. The infection was diagnosed 14.2 ± 8.22 weeks post device implantation. They were admitted for 7.6 ± 1.54 days postprocedure. The follow‐up duration was 26.5 ± 15 (1.7–52) months. Only one patient (8%) had a recurrence of the infection after 50 days of the procedure. Conclusion Our protocol was successful in treating 92% of device‐related pocket infection without the need to replace the device or the pocket side.